Med-Surg Certification Practice
Questions and answers
A newly diabetic patient will receive instructions from his nurse. Which of the following
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actions should the nurse take first?
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A. Provide the patient with brochures for making smart choices for cooking/baking.
h h h h h h h h h h h
B. Ask the patient what they know about diabetes.
h h h h h h h h
C. Instruct the patient on exercise or activities that will increase their metabolism.
h h h h h h h h h h h h
D. Teach them how to use the glucometer. - answersB.
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First ask the patient what they know about diabetes.
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*ACTION questions ask for intervention, NOT assessment h h h h h h
The post hysterectomy patient with calls the clinic stating that she has been having
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difficulty with incontinence. Which of the following statements if made by the patient,
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indicates that further teaching is needed?
h h h h h h
A. I drink 8 oz. of fluid on the even hours while awake.
h h h h h h h h h h h h
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
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C. I will only drink fluid when I eat my meals
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D. I will set the timer to remind me when to void - answersC.
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A patient saying that he or she will only drink fluids when eating meals indicates that they
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don't know what to do in case of incontinence.
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FURTHER TEACHING indicates that the patient needs more information h h h h h h h h
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The
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patient states to the RN that he is short of breath, has no appetite and hurts everywhere.
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Which of the following statements by the nurse is best?
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A. Tell me how your family is coping
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B. Show me where it does not hurt
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C. I'll teach you relaxation techniques
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D. Your physician should increase your pain medication - answersC
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A clinical nurse returns to the desk to find 4 phone messages. Which of the following
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messages should the nurse respond to first?
h h h h h h h
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
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B. A patient with multiple sclerosis complaining of change in peripheral vision.
h h h h h h h h h h h
C. A patient with a herniated disc complaining of consistent back pain.
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,D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling
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toes. - answersA
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B and C are expected symptoms of the patient's condition. A and D are unexpected. D is
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less critical than A. Best answer is A.
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A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping.
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Which of the following actions by the nurse is most appropriate?
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A. Determine the patient's usual sleeping and waking patterns.
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B. Suggest that the client abstain from alcohol and caffeine before bed time.
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C. Recommend that client establish a bedtime routine.
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D. Ask how much sleep the client required before retirement. - answersA
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B and C are recommendations that the RN can share after he/she determines the
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patient's sleeping and waking patterns. So remove B and C. D is an inquiry, but is
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concerned about the past (when the person retired). Remove D. A is the best answer.
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The nurse cares for a patient several hours after a thyroidectomy. The RN observes that
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the patient is diaphoretic and confused. The vital signs are:
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Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects
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the physician to order which of the following?
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A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
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B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po
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qld.
h
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and
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ciprofloxacin (cipro) 500 mg. po bid.
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D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. - answersB
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A 63 year old female patient contacts the clinic to report that she is has been extremely
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fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of
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the following responses by the nurse is most appropriate?
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A. You will have more energy if you walk 30 min every day.
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B. You don't need to worry. Sleeping a lot is good for you.
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C. Come in and see your health care provider today.
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D. You should eat more green leafy vegetables. - answersC
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Need more info h h
The RN performs blood pressure screening at the local community center. Which of the
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following individuals is most likely to suffer from a cerebrovascular accident?
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A. A 30 year old man who is an account executive
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B. A 40 year old man who jogs four times a week.
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,C. A 60 year old man whose father had a stroke.
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D. A 75 year old man who takes multi-vitamins. - answersC
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For the patient with a new tracheostomy, the nurse must be alert to which early
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complication?
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a) Decannulation
h
b) Infection
h
c) Bleeding
h
d) Tracheomalacia - answersC
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Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
h h h h h h h h h h h
structures, and failure of the chosen technique to achieve successful airway
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EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING. h h h h h h h h
Infection comes 2-3 days later.
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When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to
h h h h h h h h h h h h h h h h
85% over 4 hours, the nurse will first:
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1. Request an order for stat ABGs
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2. Start the patient on oxygen by NC at 2L/minute
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3. Notify the physician of the change
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4. Check the position of the probe on patient's finger or earlobe - answers4
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Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation,
h h h h h h h h h h h h h h h
nail polish, or dark skin pigmentation.
h h h h h h
To decrease a patient's shortness of breath and a sense of impending doom during an
h h h h h h h h h h h h h h
asthma attack, the nurse will:
h h h h h
A. Place the patient on a cardiac monitor and observe from the nurses' station.
h h h h h h h h h h h h h
B. Let the patient rest alone in a quiet, calm environment.
h h h h h h h h h h
C. Reassure the patient that the doctor will arrive soon
h h h h h h h h h
D. Stay with the patient and encourage pursed-lip breathing. - answersD
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The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
h h h h h h h h h h h h h
important for the nurse to stay with the patient for ongoing assessment and to provide a
h h h h h h h h h h h h h h h h
calm environment. Helping the patient breathe with pursed lips will facilitate the expiration
h h h h h h h h h h h h h
of trapped air and help the patient regain control of his or her breathing.
h h h h h h h h h h h h h h
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric
h h h h h h h h h h h h h h h h
cancer. She states that she doesn't want anyone to see her in this condition, even her
h h h h h h h h h h h h h h h h
husband. This nurse's best response is:
h h h h h h
A."Patients' rights protect your privacy. I won't allow anyone in." h h h h h h h h h
, B."I've seen gastric cancer patients who look much worse. Don't worry."
h h h h h h h h h h
C."Would you like to talk to a social worker?"
h h h h h h h h
D."What about your condition worries you?" - answersD
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The nurse should allow the patient to share her concerns and express her feelings in a
h h h h h h h h h h h h h h h
nonjudgmental environment.
h h
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
h h h h h h h h h
A patient with a tricuspid valve disorder will have impaired blood flow between the:
h h h h h h h h h h h h h
A. Vena cava and right atrium
h h h h h
B. Left atrium and left ventricle
h h h h h
C. Right atrium and right ventricle
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D. Right ventricle and pulmonary artery - answersC
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Tricuspid valve is located between right atrium and right ventricle
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MITRAL VALVE- left atrium and left ventricle
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If the Purkinje system is damaged, conduction of the electrical impulse is impaired
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hthrough the: h
A. Atriah
B. AV node
h h
C. Ventricles
h
D. Bundle of His - answersC
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Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular
h h h h h h h h h h
myocardium; if the pattern of contraction is disrupted, the ventricles will not efficiently
h h h h h h h h h h h h h
eject blood
h h
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje
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fibers
h
The P-wave on an EKG is representative of:
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A. Ventricular depolarization
h h
B. Atrial depolarization
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C. Atrial repolarization
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D. Ventricular repolarization - answersB. Atrial depolarization
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Questions and answers
A newly diabetic patient will receive instructions from his nurse. Which of the following
h h h h h h h h h h h h h
actions should the nurse take first?
h h h h h h
A. Provide the patient with brochures for making smart choices for cooking/baking.
h h h h h h h h h h h
B. Ask the patient what they know about diabetes.
h h h h h h h h
C. Instruct the patient on exercise or activities that will increase their metabolism.
h h h h h h h h h h h h
D. Teach them how to use the glucometer. - answersB.
h h h h h h h h h h
First ask the patient what they know about diabetes.
h h h h h h h h
*ACTION questions ask for intervention, NOT assessment h h h h h h
The post hysterectomy patient with calls the clinic stating that she has been having
h h h h h h h h h h h h h
difficulty with incontinence. Which of the following statements if made by the patient,
h h h h h h h h h h h h h
indicates that further teaching is needed?
h h h h h h
A. I drink 8 oz. of fluid on the even hours while awake.
h h h h h h h h h h h h
B. I will attempt to void 30 minutes after drinking 200 cc. of fluid
h h h h h h h h h h h h h
C. I will only drink fluid when I eat my meals
h h h h h h h h h h
D. I will set the timer to remind me when to void - answersC.
h h h h h h h h h h h h h h
A patient saying that he or she will only drink fluids when eating meals indicates that they
h h h h h h h h h h h h h h h h
don't know what to do in case of incontinence.
h h h h h h h h h
FURTHER TEACHING indicates that the patient needs more information h h h h h h h h
An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The
h h h h h h h h h h h h h h h
patient states to the RN that he is short of breath, has no appetite and hurts everywhere.
h h h h h h h h h h h h h h h h h
Which of the following statements by the nurse is best?
h h h h h h h h h h
A. Tell me how your family is coping
h h h h h h h
B. Show me where it does not hurt
h h h h h h h
C. I'll teach you relaxation techniques
h h h h h
D. Your physician should increase your pain medication - answersC
h h h h h h h h h
A clinical nurse returns to the desk to find 4 phone messages. Which of the following
h h h h h h h h h h h h h h h
messages should the nurse respond to first?
h h h h h h h
A. A post cervical laminectomy patient complaining of sudden difficulty talking.
h h h h h h h h h h
B. A patient with multiple sclerosis complaining of change in peripheral vision.
h h h h h h h h h h h
C. A patient with a herniated disc complaining of consistent back pain.
h h h h h h h h h h h
,D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling
h h h h h h h h h h h h h h h h h
toes. - answersA
h h h
B and C are expected symptoms of the patient's condition. A and D are unexpected. D is
h h h h h h h h h h h h h h h h
less critical than A. Best answer is A.
h h h h h h h h
A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping.
h h h h h h h h h h h h h h h
Which of the following actions by the nurse is most appropriate?
h h h h h h h h h h h
A. Determine the patient's usual sleeping and waking patterns.
h h h h h h h h
B. Suggest that the client abstain from alcohol and caffeine before bed time.
h h h h h h h h h h h h
C. Recommend that client establish a bedtime routine.
h h h h h h h
D. Ask how much sleep the client required before retirement. - answersA
h h h h h h h h h h h
B and C are recommendations that the RN can share after he/she determines the
h h h h h h h h h h h h h
patient's sleeping and waking patterns. So remove B and C. D is an inquiry, but is
h h h h h h h h h h h h h h h h
concerned about the past (when the person retired). Remove D. A is the best answer.
h h h h h h h h h h h h h h h
The nurse cares for a patient several hours after a thyroidectomy. The RN observes that
h h h h h h h h h h h h h h
the patient is diaphoretic and confused. The vital signs are:
h h h h h h h h h h
Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects
h h h h h h h h h h h h h h h h h
the physician to order which of the following?
h h h h h h h h
A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min.
h h h h h h h h
B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po
h h h h h h h h h h h h h h
qld.
h
C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and
h h h h h h h h h h h h
ciprofloxacin (cipro) 500 mg. po bid.
h h h h h h
D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. - answersB
h h h h h h h h h h h h h
A 63 year old female patient contacts the clinic to report that she is has been extremely
h h h h h h h h h h h h h h h h
fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of
h h h h h h h h h h h h h h h h h h
the following responses by the nurse is most appropriate?
h h h h h h h h h
A. You will have more energy if you walk 30 min every day.
h h h h h h h h h h h h
B. You don't need to worry. Sleeping a lot is good for you.
h h h h h h h h h h h h
C. Come in and see your health care provider today.
h h h h h h h h h
D. You should eat more green leafy vegetables. - answersC
h h h h h h h h h
Need more info h h
The RN performs blood pressure screening at the local community center. Which of the
h h h h h h h h h h h h h
following individuals is most likely to suffer from a cerebrovascular accident?
h h h h h h h h h h h
A. A 30 year old man who is an account executive
h h h h h h h h h h
B. A 40 year old man who jogs four times a week.
h h h h h h h h h h h
,C. A 60 year old man whose father had a stroke.
h h h h h h h h h h
D. A 75 year old man who takes multi-vitamins. - answersC
h h h h h h h h h h
For the patient with a new tracheostomy, the nurse must be alert to which early
h h h h h h h h h h h h h h
complication?
h
a) Decannulation
h
b) Infection
h
c) Bleeding
h
d) Tracheomalacia - answersC
h h h h
Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent
h h h h h h h h h h h
structures, and failure of the chosen technique to achieve successful airway
h h h h h h h h h h h
EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING. h h h h h h h h
Infection comes 2-3 days later.
h h h h h
When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to
h h h h h h h h h h h h h h h h
85% over 4 hours, the nurse will first:
h h h h h h h h
1. Request an order for stat ABGs
h h h h h h
2. Start the patient on oxygen by NC at 2L/minute
h h h h h h h h h
3. Notify the physician of the change
h h h h h h
4. Check the position of the probe on patient's finger or earlobe - answers4
h h h h h h h h h h h h h
Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation,
h h h h h h h h h h h h h h h
nail polish, or dark skin pigmentation.
h h h h h h
To decrease a patient's shortness of breath and a sense of impending doom during an
h h h h h h h h h h h h h h
asthma attack, the nurse will:
h h h h h
A. Place the patient on a cardiac monitor and observe from the nurses' station.
h h h h h h h h h h h h h
B. Let the patient rest alone in a quiet, calm environment.
h h h h h h h h h h
C. Reassure the patient that the doctor will arrive soon
h h h h h h h h h
D. Stay with the patient and encourage pursed-lip breathing. - answersD
h h h h h h h h h h h
The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is
h h h h h h h h h h h h h
important for the nurse to stay with the patient for ongoing assessment and to provide a
h h h h h h h h h h h h h h h h
calm environment. Helping the patient breathe with pursed lips will facilitate the expiration
h h h h h h h h h h h h h
of trapped air and help the patient regain control of his or her breathing.
h h h h h h h h h h h h h h
A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric
h h h h h h h h h h h h h h h h
cancer. She states that she doesn't want anyone to see her in this condition, even her
h h h h h h h h h h h h h h h h
husband. This nurse's best response is:
h h h h h h
A."Patients' rights protect your privacy. I won't allow anyone in." h h h h h h h h h
, B."I've seen gastric cancer patients who look much worse. Don't worry."
h h h h h h h h h h
C."Would you like to talk to a social worker?"
h h h h h h h h
D."What about your condition worries you?" - answersD
h h h h h h h h
The nurse should allow the patient to share her concerns and express her feelings in a
h h h h h h h h h h h h h h h
nonjudgmental environment.
h h
If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING
h h h h h h h h h
A patient with a tricuspid valve disorder will have impaired blood flow between the:
h h h h h h h h h h h h h
A. Vena cava and right atrium
h h h h h
B. Left atrium and left ventricle
h h h h h
C. Right atrium and right ventricle
h h h h h
D. Right ventricle and pulmonary artery - answersC
h h h h h h h
Tricuspid valve is located between right atrium and right ventricle
h h h h h h h h h
MITRAL VALVE- left atrium and left ventricle
h h h h h h
If the Purkinje system is damaged, conduction of the electrical impulse is impaired
h h h h h h h h h h h h
hthrough the: h
A. Atriah
B. AV node
h h
C. Ventricles
h
D. Bundle of His - answersC
h h h h h
Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular
h h h h h h h h h h
myocardium; if the pattern of contraction is disrupted, the ventricles will not efficiently
h h h h h h h h h h h h h
eject blood
h h
Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje
h h h h h h h h h h h h h h h h h
fibers
h
The P-wave on an EKG is representative of:
h h h h h h h
A. Ventricular depolarization
h h
B. Atrial depolarization
h h
C. Atrial repolarization
h h
D. Ventricular repolarization - answersB. Atrial depolarization
h h h h h h
